Healthcare Provider Details

I. General information

NPI: 1568807659
Provider Name (Legal Business Name): EMERGING MILESTONES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2013
Last Update Date: 09/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1172 MURPHY AVE SUITE 201-202
SAN JOSE CA
95131-2429
US

IV. Provider business mailing address

PO BOX 731253
SAN JOSE CA
95173-1253
US

V. Phone/Fax

Practice location:
  • Phone: 408-728-8476
  • Fax: 510-371-9608
Mailing address:
  • Phone: 408-728-8476
  • Fax: 510-371-9608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJAN THINDA
Title or Position: PRESIDENT / CEO
Credential: MBBS
Phone: 408-876-8281